接触镜在全球的应用日益广泛,配适方法的不断进步是目前接触镜安全性、舒适性不断提高的原因之一。在接触镜适配过程中,越来越多的先进影像技术被运用于指导接触镜的配适,这些技术的出现简化了接触镜适配的过程,为临床医生进行简便、准确、个性化的接触镜适配提供了帮助,也为接触镜的个性化设计提供了参考数据。
Contact lens has been widely applied worldwide, and the advancement of fitting strategy is one of the reasons which improve the safety and comfort of contact lens fitting. During the contact lens fitting procedure, more and more ophthalmic imaging modalities have been applied to guide the contact lens fitting. These techniques simplify the contact lens fitting procedure, help optometrists accurately perform the customize contact lens fitting, and assist the personalized contact lens design technique.
目的:获取眼表图像的综合信息,建立眼表疾病综合诊断和评估。方法:将超高分辨率光学相干断层成像仪(ultra-high resolution optical coherence tomography,UHR-OCT)与基于裂隙灯生物显微镜的微血管成像系统相结合,开发了一种多模态、非接触式的眼科光学成像平台。结果:UHR-OCT模块在组织中实现轴向分辨率约为2 μm 。眼表微血管成像模块在最大放大倍率下横向分辨率约为3.5 μm。通过集成在裂隙灯显微镜成像光学路径的不同模块,多模态成像平台能够执行实时前段OCT结构成像、结膜微血管成像和传统裂隙灯成像功能。利用自主开发的软件,进一步分析结膜血管网络图像和血流图像,获取血管分形维数、血流速度、血管直径等定量形态学和血流动力学参数。结论:通过在健康受试者和角膜炎患者的在体成像测试,表明多模态眼前段成像设备可为眼科临床应用及人工智能提供结构和功能信息数据。
Objective: To obtain the comprehensive information of the anterior eye image, establish complementary information for the diagnosis and evaluation of ocular diseases. Methods: We developed a multi-modal, non-invasive optical imaging platform by combining ultra-high resolution optical coherence tomography (UHR-OCT) with a microvascular imaging system based on slit-lamp biomicroscopy. Results: The uHR-OCT module achieved an axial resolution of approximately 2 μm in tissues. The lateral resolution of the ocular surface microvascular imaging module under maximum magnification was approximately 3.5 μm. By combining the imaging optical paths of different modules, the customized multi-modal eye imaging platform was capable of performing real-time cross-sectional UHR-OCT imaging of the anterior eye, conjunctival vessel network imaging, high-resolution conjunctival blood flow videography, and traditional slit-lamp imaging on a single device. With self-developed software, a conjunctival vessel network image and blood flow videography were further analyzed to acquire quantitative morphological and hemodynamics parameters, including vessel fractal dimensions, blood flow velocity and vessel diameters. Conclusion: The ability of the multi-modal anterior eye imager to provide both structural and functional information for ophthalmic clinical applications can be demonstrated in a healthy human subject and a keratitis patient.
目的:分析人眼的睑板腺形态学特征,探索睑板腺分析系统在眼表疾病的应用研究。方法:中山眼科中心入组正常受试者24例(42眼),进行睑板腺红外摄影。选取受试者中的10例(20眼)在同型号的设备上由二名操作员分别进行睑板腺红外摄影。图像通过自行设计的分析软件对上睑结膜中央5条腺体形态学参数进行定量分析,对数据进行重复性测试。结果:测量的生物参数腺体直径为(0.48±0.09) mm,腺体长度为(5.25±0.68) mm,腺体面积为(2.12±0.53) mm,腺体形变系数为10.01±3.85,显影值为6.32±1.23,中央五条腺体占中央区域面积百分比为(10.94±2.20)%,腺体占上睑结膜面积百分比为(58.07±8.13)%。各指标两次测量值差异无统计学意义(P>0.05)。重复性分析结果显示:腺体各项生物参数的变异系数(coefficients of variation,CV)均小于5%,组内变异系数(intraclass correlation coefficient,ICC)均大于0.95。结论:睑板腺综合分析系统对腺体的形态学分析有良好的可靠性和一致性,有望为临床上对睑板腺腺体功能评估提供新的非侵入性参考指标。
Objective: To analyze the morphological characteristics of meibomian glands in human eyes and to explore the application research of meibomian glands analysis system in ocular surface diseases. Methods: A total of 24 healthy subjects were recruited by Zhongshan Ophthalmic Center to infrared photography of meibomian glands. Ten of healthy subjects were selected by the two operators for infrared photography of meibomian glands on the same model of equipment. The images were repeatedly measured and analyzed by the self-designed analysis software on the morphological measurements of the five glands in the center of the upper eyelid. Results: The measured biological parameters are shown below: the average gland diameter was (0.48±0.09) mm, the average gland length was (5.25±0.68) mm, the average gland area was (2.12±0.53) mm, the gland deformation coefficient was 10.01±3.85, the development value was 6.32±1.23, the percentage of the five central glands in the central area was (10.94±2.20)%, and the glands accounted for (58.07±8.13)% of the upper conjunctiva area. There was no statistical difference between the two measurements of each index (P>0.05). Repeatability analysis results showed that coefficients of variation (CV) of all biological parameters of glands were less than 5% and the intraclass correlation coefficient (ICC) in both groups were greater than 0.95. Conclusion: The Meibomian Gland Bioimage Analyzer provides good reliability and consistency for morphological measurements of the meibomian gland, and it is expected to provide new non-invasive indicators for clinical assessment of the meibomian glands function.
目的:针对活体共聚焦显微镜(in vivo confocal microscopy,IVCM)和传统光学相干层析技术(optical coherence tomography,OCT)在人眼角膜成像各自存在成像视野小或无法细胞成像的限制,开发具有高分辨率的非接触全视场光学相干层析系统(full-field optical coherence tomography,FFOCT),实现活体人眼角膜细胞结构FFOCT成像。方法:FFOCT系统采用高数值孔径干燥显微物镜及高速面阵相机,使用双相位调制图像处理方法,实现系统高速高分辨率非接触成像。利用系统对健康人眼进行角膜各深度层的活体FFOCT成像验证其可行性。结果:本研究团队研发了FFOCT的新型活体人眼角膜高分辨率成像系统,实现理论平面成像分辨率1.7 μm,成像视野1.26 mm×1.26 mm,成像速率达275帧/s。利用该系统对正常活体人眼角膜成像实验,在非接触情况下获取了角膜各主要结构层的高分辨率结构影像。结论:FFOCT高分辨率活体人眼角膜成像系统兼具了传统OCT的非接触、大成像视野及IVCM的细胞级别平面分辨率的优势,将为角膜疾病的研究及临床诊疗提供全新的成像分析技术。
Objective: Due to the limitations of small imaging field of view of in vivo confocal microscopy (IVCM) or the incapability of cellular imaging of traditional optical coherence tomography (OCT) in human corneal imaging, this study was designed to develop a novel high-resolution in vivo human corneal imaging system based on full-field OCT (FFOCT). Methods: The FFOCT system utilized a high numerical aperture air immersion microscope objective and a high-speed area array CMOS camera with two-phase modulation image processing algorithm to achieve high-speed high-resolution non-contact imaging of human cornea. To verify its feasibility, in vivo cornea imaging at different depth was performed on a healthy human subject. Results: The FFOCT system achieved a theoretical lateral imaging resolution of 1.7 μm, an imaging field of view of 1.26 mm×1.26 mm, and an imaging rate of 275 Hz/s. High-resolution FFOCT images of the main structural layers of cornea were achieved by imaging a healthy human cornea in vivo with this system in a non-contact way. Conclusion: The FFOCT human corneal imaging system combines the advantages of the non-contractness and the large imaging field of view of traditional OCT with the cellular lateral resolution of IVCM, potentially providing a new imaging system for the research and clinical diagnosis and treatment of corneal diseases.
视网膜疾病大多以周边视网膜病变为首要表现,后者的早期诊断、监测对于视网膜疾病的治疗及预防起着至关重要的作用。以往传统眼底成像技术仅能提供20°视网膜的可视范围,即便使用蒙太奇拍摄技术,也只能采集部分眼底范围。目前眼底成像技术已步入最新的超广角时代,其所提供的眼底视野至少可达200°,并且基于该技术的超广角眼底彩色照相、荧光素血管造影、光学相干断层扫描及其血管造影等已广泛应用于临床实践中,对于诊断及评估视网膜疾病发挥重要作用,如糖尿病性视网膜病变、视网膜静脉阻塞、早产儿视网膜病变、视网膜色素变性及视网膜脱离等。本文将从超广角成像技术的产生、发展及其国内外的临床应用现状作一综述,旨在为临床工作及研究提供指导意义。
Retinal diseases primarily feature with peripheral retinopathy, and its early diagnosis as well as the later following up both play a vital role in the treatment and prevention of retinal diseases. In the past, traditional fundus imaging technology can only provide the visual range of 20 degrees. Even if montage photography technology is used, it can only partially reveal the fundus field. At present, fundus imaging technology has entered the latest era of ultra-wide-field, which provides at least 200-degree fundus field of vision. Ultra-wide-field fundus photochromy, fluorescein angiography, optical coherence tomography and angiography based on this technology have been widely used in clinical practice, and play an important role in the diagnosis and evaluation of retinal diseases, such as diabetes retinopathy, retinal vein occlusion, retinopathy of prematurity, retinitis pigmentosa and retinal detachment. This article aims to review the occurrence and development of ultra-wide-field fundus imaging technology and its clinical applications up to now to provide a relative guideline for clinic and research.
眼缺血综合征(ocular ischemia syndrome,OIS)是由一系列诱因引发的以慢性眼部低灌注为主要临床表现的眼部疾病。临床相对少见,但对视力的影响较大,其症状主要包括一过性黑朦、缺血性眼痛、永久性视力丧失等。近年来医疗美容行业逐步兴起,自体脂肪填充技术使用逐渐增多,其所引起的OIS不可忽视。本文分析1例自体脂肪填充患者术后致OIS病例,研究该类疾病眼底影像学特征。
Ocular ischemia syndrome (OIS), featuring as chronic ocular hypoperfusion, is an eye disease caused by a series of incentives. It is relatively rare in clinical practice, but has a great impact on vision. The symptoms of OIS mainly include transient amaurosis, ischemic eye pain, permanent vision loss, etc. In recent years, with the rise of the Aesthetic Medicine industry, the technology of autologous fat filling has been increasingly adopted. The OIS caused by the surgery of autologous fat filling is nonnegligible. In this paper, by means of analyzing a case that an autologous fat filling surgery resulted in the OIS, discusses features of fundus angiography of OIS.